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COPY <br /> EHD LOG# Z <br /> G. MANDATORY CONTACTS <br /> San Joaquin County Environmental Health Donna Heran < Time: Date: , <br /> Department <br /> U/Vl a 1 <br /> San Joaquin County Board of Supervisors— Michael Cockrell Time: Date: <br /> Contact—Office of Emergency Services <br /> H. HEALTH AND SAFETY CODE 25180.7 <br /> (b) Any designated government employee who obtains information in the course of his official duties <br /> revealing the illegal discharge or threatened illegal discharge of a hazardous waste within the <br /> geographical area of his jurisdiction and who knows that such discharge or threatened discharge is <br /> likely to cause substantial injury to the public health or safety must, within seventy-two hours, disclose <br /> such information to the local Board of Supervisors and to the local health officer. No disclosure if <br /> information is required under this subdivision when otherwise prohibited by law, or when law <br /> enforcement personnel have determined that such disclosure would adversely affect an ongoing <br /> criminal investigation, or when the information is already general public knowledge within the locality <br /> affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and intentionally fails to disclose information <br /> required to be disclosed under subdivision (b) shall, upon conviction, be punished by imprisonment in <br /> the county jail for not more than one year or by imprisonment in state prison for not more than three <br /> years. The court may also impose upon the person a fine of not less than five thousand dollars <br /> ($5000) or more than twenty-five thousand dollars ($25,000). The felony conviction for violation of this <br /> section shall require forfeiture of government employment within thirty days of conviction. <br /> [. SIGNATURE DISCLOSURE <br /> I make this report on behalf of all designated employees of the County of San Joaquin, and <br /> San Joaquin County Environmental Health Department <br /> (Agency Name) <br /> Signature: 464/ �� <br /> Printed Name: G ett Backus <br /> Title: Lead S6ior Registered Environmental Health Specialist <br /> Date: Monday, August 18, 2014 Time: 4:08 pm <br /> cc: DTSC Site Code: <br /> CVRWQCB piton <br /> 6,%+y 0-F ImN &yfftggers o�iu_ 333 C,r17C'�/ Referr tlR Yes No <br /> -Trace CA qS51P <br /> t-e-5PO s�blt t'otri5 levcvlc( i-uJ- Af-f,0.P [evail(y zcICo9z SanduWge t7, Val&'crq CA 1Y255!1Y255! <br /> 0-W'-)err u r 5 A Le o eind-"Tr £W (z f*n A4e-'7mcy i? 95574- <br /> Revised <br /> 537(vRevised 08/02/12 Page 2 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />